Infectious endocarditis by Bartonella species. Report of two cases

ABSTRACT Infectious endocarditis (IE) by Bartonella species is an emerging problem worldwide. We report two cases of native valve Bartonella-associated IE events, both affecting adult male patients with a history of alcohol abuse and a low socioeconomic status. Admissions were due to pancytopenia an...

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Autores principales:	Delama,Ignacio, Mondaca,Roberto, Aguayo,Ignacia, Roldán,Andrés, Ferrés,Marcela, Fica,Alberto
Lenguaje:	English
Publicado:	Sociedad Médica de Santiago 2019
Materias:	Bartonella Endocarditis, Bacterial Fluorescent Antibody Technique, Indirect Sequence Analysis, DNA Stroke
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019001001340
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spelling	oai:scielo:S0034-988720190010013402020-01-16Infectious endocarditis by Bartonella species. Report of two casesDelama,IgnacioMondaca,RobertoAguayo,IgnaciaRoldán,AndrésFerrés,MarcelaFica,Alberto Bartonella Endocarditis, Bacterial Fluorescent Antibody Technique, Indirect Sequence Analysis, DNA Stroke ABSTRACT Infectious endocarditis (IE) by Bartonella species is an emerging problem worldwide. We report two cases of native valve Bartonella-associated IE events, both affecting adult male patients with a history of alcohol abuse and a low socioeconomic status. Admissions were due to pancytopenia and bleeding in one case and embolic stroke in the other. Blood cultures were negative and IgG indirect immunofluorescence assays (IFA) were positive for B. henselae/B. quintana in high titers (1/16,384-1/16,384, and 1/32,768 -1/16,384, respectively). Cases were classified as definitive IE events according to modified Duke criteria due to the presence of valve vegetations with at least three minor criteria. One patient required aortic mechanical valve replacement and survived, and the other died after a massive hemorrhagic transformation of his stroke. PCR amplification and sequencing of the 16S ribosomal bacterial DNA from a valve tissue sample obtained at surgery in the patient who survived, confirmed B. quintana as the etiological agent. Bartonella-associated IE is an emerging problem in Chile, present in disadvantaged populations. It should be suspected in patients with culture-negative IE. IFA does not discriminate between B. henselae and B. quintana infection, but high titers suggest IE. Complementary PCR techniques may help to elucidate the final causative agent.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.147 n.10 20192019-10-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019001001340en10.4067/s0034-98872019001001340
institution	Scielo Chile
collection	Scielo Chile
language	English
topic	Bartonella Endocarditis, Bacterial Fluorescent Antibody Technique, Indirect Sequence Analysis, DNA Stroke
spellingShingle	Bartonella Endocarditis, Bacterial Fluorescent Antibody Technique, Indirect Sequence Analysis, DNA Stroke Delama,Ignacio Mondaca,Roberto Aguayo,Ignacia Roldán,Andrés Ferrés,Marcela Fica,Alberto Infectious endocarditis by Bartonella species. Report of two cases
description	ABSTRACT Infectious endocarditis (IE) by Bartonella species is an emerging problem worldwide. We report two cases of native valve Bartonella-associated IE events, both affecting adult male patients with a history of alcohol abuse and a low socioeconomic status. Admissions were due to pancytopenia and bleeding in one case and embolic stroke in the other. Blood cultures were negative and IgG indirect immunofluorescence assays (IFA) were positive for B. henselae/B. quintana in high titers (1/16,384-1/16,384, and 1/32,768 -1/16,384, respectively). Cases were classified as definitive IE events according to modified Duke criteria due to the presence of valve vegetations with at least three minor criteria. One patient required aortic mechanical valve replacement and survived, and the other died after a massive hemorrhagic transformation of his stroke. PCR amplification and sequencing of the 16S ribosomal bacterial DNA from a valve tissue sample obtained at surgery in the patient who survived, confirmed B. quintana as the etiological agent. Bartonella-associated IE is an emerging problem in Chile, present in disadvantaged populations. It should be suspected in patients with culture-negative IE. IFA does not discriminate between B. henselae and B. quintana infection, but high titers suggest IE. Complementary PCR techniques may help to elucidate the final causative agent.
author	Delama,Ignacio Mondaca,Roberto Aguayo,Ignacia Roldán,Andrés Ferrés,Marcela Fica,Alberto
author_facet	Delama,Ignacio Mondaca,Roberto Aguayo,Ignacia Roldán,Andrés Ferrés,Marcela Fica,Alberto
author_sort	Delama,Ignacio
title	Infectious endocarditis by Bartonella species. Report of two cases
title_short	Infectious endocarditis by Bartonella species. Report of two cases
title_full	Infectious endocarditis by Bartonella species. Report of two cases
title_fullStr	Infectious endocarditis by Bartonella species. Report of two cases
title_full_unstemmed	Infectious endocarditis by Bartonella species. Report of two cases
title_sort	infectious endocarditis by bartonella species. report of two cases
publisher	Sociedad Médica de Santiago
publishDate	2019
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019001001340
work_keys_str_mv	AT delamaignacio infectiousendocarditisbybartonellaspeciesreportoftwocases AT mondacaroberto infectiousendocarditisbybartonellaspeciesreportoftwocases AT aguayoignacia infectiousendocarditisbybartonellaspeciesreportoftwocases AT roldanandres infectiousendocarditisbybartonellaspeciesreportoftwocases AT ferresmarcela infectiousendocarditisbybartonellaspeciesreportoftwocases AT ficaalberto infectiousendocarditisbybartonellaspeciesreportoftwocases
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Infectious endocarditis by Bartonella species. Report of two cases

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